2型糖尿病合并冠心病患者行冠脉搭桥术围手术期血糖水平对术后急性肾损伤及康复影响的研究  

Influence of perioperative blood glucose level on postoperative acute kidney injury and rehabilitation in diabetic patients undergoing coronary artery bypass grafting

作　　者：苑雯雯 赵冬 逄珺 路长鸿 YUAN Werrwen;ZHAO Domng;PANG Jun(Department of Cardiology,Qingdao Fuaai Cardiouascular Hospital,Qingdao 266000,China)

机构地区：[1]青岛阜外心血管病医院心内科,青岛266000 [2]青岛阜外心血管病医院ICU,青岛266000

出　　处：《中国糖尿病杂志》2025年第3期184-188,共5页Chinese Journal of Diabetes

基　　金：青岛市科技惠民示范引导专项任务书(21-1-4-rkjk-21-nsh)。

摘　　要：目的 探讨T2DM合并冠心病患者行冠脉搭桥术(CABG)围手术期BG水平对术后急性肾损伤(AKI)及康复的影响。方法 随机选取2022年1~12月于青岛阜外心血管病医院心内科行CABG治疗的142例T2DM患者,根据BG控制情况分为控制良好组(n=57)和控制不良组(n=85),比较两组BG、AKI发生率、心功能改善情况及生活质量等。结果 控制良好组手术时间、呼吸机使用时间、重症监护室时间、住院时间、各项BG指标均低于控制不良组(P<0.05或P<0.01)。两组共27例(19.01%)患者术后发生AKI,控制良好组AKI发生率低于控制不良组(10.53%vs 24.71%,P<0.05)。两组治疗后心功能指标较术前显著改善,且控制良好组心功能、生活质量优于控制不良组(P<0.01)。结论 T2DM合并冠心病患者CABG术后AKI发生率为19.01%,围手术期BG水平控制良好者可减少术后AKI风险,有利于术后早期康复。Objective To investigate the effects of perioperative blood glucose(BG)levels on postoperative acute kidney injury(AKI)and rehabilitation in diabetic patients with coronary heart disease after coronary artery bypass grafting(CABG).Methods Randomly select data from 142 patients who underwent CABG treatment at The Fuwai Cardiovascular Hospital in Qingdao from January to December 2022,and compare the BG indicators,AKI incidence,cardiac function improvement and quality of life between good control group(n=57)and poor control group(n=85).Results The operation time,ventilator use time,postoperative ICU time,hospital stay time and various BG indexes in the good control group were significantly lower than those in the poor control group(P<0.05 or P<0.01).27 patients(19.01%)developed AKI after surgery,and the incidence of AKI in the good control group was significantly lower than that in the poor control group(10.53%us 24.71%,P<0.05).After treatment,the cardiac function indexes in both groups were significantly improved compared with those before surgery,and the good control had significantly better cardiac function and quality of life than the poor control(P<0.05).Conclusions The incidence of AKI after CABG in patients with diabetes and coronary heart disease was 19.01%.Good perioperative BG level control can reduce the risk of postoperative AKI and help early postoperative recovery.

关 键 词：冠脉搭桥术 冠心病 糖尿病 急性肾损伤 围手术期 血糖 康复 

分 类 号：R654.2[医药卫生—外科学]